Provider First Line Business Practice Location Address:
1ST DENTAL BATTALION, NAVAL DENTAL CENTER
Provider Second Line Business Practice Location Address:
CAMP PENDLETON MARINE BASE
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055-5221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-5102
Provider Business Practice Location Address Fax Number:
760-725-5779
Provider Enumeration Date:
10/19/2005